My biggest problem with this letter is that "medical personnel" is included. what exactly are you trying to prevent them from having to do? If you are a medical professional and refuse to respect or help people who identify as LGBTQI than you are in the wrong profession. I fail to see the problem here. Christians, especially Lutherans have always held power and privilege in this society and the second you may have to share that power you get scared. I do not see God in this letter. I see disrespect and close mindedness.